{"id":25354,"date":"2023-04-22T11:04:30","date_gmt":"2023-04-22T04:04:30","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25354"},"modified":"2023-04-22T11:04:30","modified_gmt":"2023-04-22T04:04:30","slug":"phuong-phap-dat-dien-cuc-sau-dieu-tri-benh-parkinson","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/phuong-phap-dat-dien-cuc-sau-dieu-tri-benh-parkinson\/","title":{"rendered":"Ph\u01b0\u01a1ng ph\u00e1p \u0111\u1eb7t \u0111i\u1ec7n c\u1ef1c s\u00e2u \u0111i\u1ec1u tr\u1ecb b\u1ec7nh Parkinson"},"content":{"rendered":"

B\u1ec7nh Parkinson l\u00e0 b\u1ec7nh tho\u00e1i ho\u00e1 c\u00e1c t\u1ebf b\u00e0o th\u1ea7n kinh h\u1ec7 dopaminergic. Nguy\u00ean nh\u00e2n c\u1ee7a b\u1ec7nh do tho\u00e1i ho\u00e1 c\u1ee7a c\u00e1c t\u1ebf b\u00e0o trong v\u00f9ng \u0111\u1eb7c c\u1ee7a li\u1ec1m \u0111en v\u00e0 li\u1ec1m xanh. K\u00edch th\u00edch n\u00e3o s\u00e2u (deep brain stimulation- DBS<\/a>) v\u00e0o nh\u00e2n d\u01b0\u1edbi \u0111\u1ed3i th\u1ecb \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho ng\u01b0\u1eddi b\u1ec7nh Parkinson th\u1ea5t b\u1ea1i v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c. \u0110\u00e2y l\u00e0 ph\u01b0\u01a1ng ph\u00e1p gi\u00fap b\u1ec7nh nh\u00e2n Parkinson c\u00f3 th\u1ec3 gi\u1ea3m \u0111\u01b0\u1ee3c c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh v\u00e0 c\u1ea3i thi\u1ec7n s\u1ee9c kh\u1ecfe c\u1ea3 v\u1ec1 th\u1ec3 ch\u1ea5t v\u00e0 tinh th\u1ea7n.<\/strong><\/p>\n

\"Ph\u01b0\u01a1ng
Ph\u01b0\u01a1ng ph\u00e1p DBS \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho ng\u01b0\u1eddi b\u1ec7nh Parkinson th\u1ea5t b\u1ea1i v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c<\/figcaption><\/figure>\n

1. Ch\u1ec9 \u0111\u1ecbnh c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p \u0111\u1eb7t \u0111i\u1ec7n c\u1ef1c s\u00e2u<\/b><\/h2>\n

– Ch\u1ec9 \u0111\u1ecbnh khi ng\u01b0\u1eddi b\u1ec7nh th\u1ea5t b\u1ea1i v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c. Th\u01b0\u1eddng l\u00e0 Parkinson n\u1eeda ng\u01b0\u1eddi, kh\u00f4ng c\u00f3 suy gi\u1ea3m tr\u00ed nh\u1edb, kh\u00f4ng qu\u00e1 gi\u00e0 (tr\u00ean 70 tu\u1ed5i), kh\u00f4ng \u0111ang m\u1eafc nh\u1eefng b\u1ec7nh n\u1eb7ng kh\u00e1c (nh\u01b0 b\u1ec7nh tim, ph\u1ed5i, ung th\u01b0, suy th\u1eadn).<\/p>\n

– B\u1ec7nh \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn v\u1eadn \u0111\u1ed9ng tr\u1ea7m tr\u1ecdng.<\/p>\n

– Lo\u1ea1n \u0111\u1ed9ng.<\/p>\n

– Run r\u1ea5t n\u1eb7ng kh\u00f4ng th\u1ec3 ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c b\u1eb1ng thu\u1ed1c.<\/p>\n

– R\u1ed1i lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 g\u00e2y \u0111au.<\/p>\n

– Thu\u1ed1c g\u00e2y t\u00e1c d\u1ee5ng ph\u1ee5, l\u00e0m ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng th\u1ec3 duy tr\u00ec thu\u1ed1c (thu\u1ed1c g\u00e2y n\u00ean t\u00e1c d\u1ee5ng ph\u1ee5 lo\u1ea1n th\u1ea7n, n\u00f4n, bu\u1ed3n n\u00f4n).<\/p>\n

2. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/b><\/h2>\n

Ng\u01b0\u1eddi b\u1ec7nh sa s\u00fat tr\u00ed tu\u1ec7, r\u1ed1i lo\u1ea1n nh\u1eadn th\u1ee9c, lo\u1ea1n th\u1ea7n (kh\u00f4ng do thu\u1ed1c).<\/p>\n

3. C\u00e1c b\u01b0\u1edbc ti\u1ebfn h\u00e0nh ph\u01b0\u01a1ng ph\u00e1p \u0111\u1eb7t \u0111i\u1ec7n c\u1ef1c s\u00e2u<\/h2>\n

3.1. Chu\u1ea9n b\u1ecb<\/b><\/h3>\n

3.1.1. Ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n:<\/b><\/h4>\n

– K\u00edp m\u1ed5:<\/p>\n

+ B\u00e1c s\u1ef9: 1 ph\u1eabu thu\u1eadt vi\u00ean ch\u00ednh + 1 b\u00e1c s\u1ef9 ph\u1ee5 m\u1ed5.<\/p>\n

+ B\u00e1c s\u1ef9 n\u1ed9i th\u1ea7n kinh: 1 b\u00e1c s\u1ef9 n\u1ed9i th\u1ea7n kinh + 1 k\u1ef9 thu\u1eadt vi\u00ean \u0111i\u1ec1u ch\u1ec9nh m\u00e1y ghi d\u00f2ng \u0111i\u1ec7n.<\/p>\n

+ \u0110i\u1ec1u d\u01b0\u1ee1ng: 2 \u0111i\u1ec1u d\u01b0\u1ee1ng g\u1ed3m 1 \u0111i\u1ec1u d\u01b0\u1ee1ng d\u1ee5ng c\u1ee5 (chu\u1ea9n b\u1ecb v\u00e0 tr\u1ee3 gi\u00fap d\u1ee5ng c\u1ee5 ph\u1eabu thu\u1eadt) + 1 \u0111i\u1ec1u d\u01b0\u1ee1ng ch\u1ea1y ngo\u00e0i ph\u1ee5c v\u1ee5 cho ca m\u1ed5.<\/p>\n

– K\u00edp g\u00e2y m\u00ea: 1 b\u00e1c s\u1ef9 g\u00e2y m\u00ea + 1 \u0111i\u1ec1u d\u01b0\u1ee1ng ph\u1ee5 m\u00ea.<\/p>\n

3.1.2. Ph\u01b0\u01a1ng ti\u1ec7n:<\/b><\/h4>\n

– Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c m\u00ea n\u1ed9i kh\u00ed qu\u1ea3n, n\u00ean ph\u00f2ng m\u1ed5 ph\u1ea3i \u0111\u1ea3m b\u1ea3o \u0111\u1ee7 trang thi\u1ebft b\u1ecb \u0111\u1ec3 ti\u1ebfn h\u00e0nh m\u00ea n\u1ed9i kh\u00ed qu\u1ea3n.<\/p>\n

– B\u1ed9 d\u1ee5ng c\u1ee5 m\u1edf s\u1ecd chuy\u00ean d\u1ee5ng cho Parkinson.<\/p>\n

– Khung \u0111\u1ecbnh v\u1ecb (Stereotaxy).<\/p>\n

– \u0110i\u1ec7n c\u1ef1c s\u00e2u, thi\u1ebft b\u1ecb ph\u00e1t xung \u0111i\u1ec7n k\u00edch th\u00edch (Implantable pulse generator – IPG), m\u00e1y k\u00edch th\u00edch \u0111i\u1ec7n, b\u1ed9 \u0111i\u1ec1u ch\u1ec9nh c\u01b0\u1eddng \u0111\u1ed9 d\u00f2ng \u0111i\u1ec7n (n\u1eb1m trong b\u1ed9 m\u1ed5 Parkinson).<\/p>\n

– M\u00e1y ch\u1ee5p C-Arm<\/p>\n

– V\u1eadt t\u01b0 ti\u00eau hao:<\/p>\n

+ 100 g\u1ea1c con; 20 g\u00f3i b\u00f4ng s\u1ecd; 5 s\u1ee3i ch\u1ec9 prolen 4.0; 5 s\u1ee3i ch\u1ec9 prolen 5.0; 5 s\u1ee3i ch\u1ec9 vicryl 2.0 (3.0 \u0111\u1ed1i v\u1edbi tr\u1ebb em); 1 g\u00f3i c\u1ea9m m\u00e1u surgicel; 1 g\u00f3i spongel; 2 g\u00f3i s\u00e1p s\u1ecd.<\/p>\n

+ B\u1ed9 d\u1eabn l\u01b0u n\u00e3o th\u1ea5t ra ngo\u00e0i (n\u1ebfu c\u1ea7n).<\/p>\n

3.1.3. Ng\u01b0\u1eddi b\u1ec7nh:<\/b><\/h4>\n

Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c c\u1ea1o t\u00f3c s\u1ea1ch s\u1ebd, v\u1ec7 sinh v\u00f9ng m\u1ed5.<\/p>\n

3.1.4. H\u1ed3 s\u01a1 b\u1ec7nh \u00e1n:<\/b><\/h4>\n

– \u0110\u1ee7 th\u1ee7 t\u1ee5c h\u00e0nh ch\u00ednh<\/p>\n

– Ph\u1ea7n chuy\u00ean m\u00f4n: c\u1ee5 th\u1ec3, \u0111\u1ee7 c\u00e1c tri\u1ec7u ch\u1ee9ng, di\u1ec5n bi\u1ebfn, ti\u1ec1n s\u1eed, c\u00e1c phim ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb, c\u00e1c x\u00e9t nghi\u1ec7m ph\u1ee5c v\u1ee5 ph\u1eabu thu\u1eadt. Ch\u1ec9 \u0111\u1ecbnh m\u1ed5, gi\u1ea3i th\u00edch r\u00f5 gia \u0111\u00ecnh v\u00e0 vi\u1ebft cam k\u1ebft m\u1ed5.<\/p>\n

3.2. C\u00e1c b\u01b0\u1edbc ti\u1ebfn h\u00e0nh<\/b><\/h3>\n

3.2.1. Ki\u1ec3m tra h\u1ed3 s\u01a1: <\/b><\/h4>\n

10 ph\u00fat \u0111\u1ea3m b\u1ea3o \u0111\u1ee7 c\u00e1c th\u1ee7 t\u1ee5c v\u00e0 \u0111\u1ec1 m\u1ee5c<\/p>\n

3.2.2. Ki\u1ec3m tra ng\u01b0\u1eddi b\u1ec7nh: <\/b><\/h4>\n

\u0110\u00fang t\u00ean, tu\u1ed5i, chu\u1ea9n b\u1ecb m\u1ed5 tr\u01b0\u1edbc 10 ph\u00fat (c\u1ea1o t\u00f3c, l\u00e0m v\u1ec7 sinh\u2026)<\/p>\n

3.2.3. Th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt:<\/b><\/h4>\n

L\u1ea7n m\u1ed5 th\u1ee9 1:<\/b><\/p>\n

–\u00a0B\u01b0\u1edbc 1:\u00a0<\/b>\u0110\u1ea7u ng\u01b0\u1eddi b\u1ec7nh s\u1ebd \u0111\u01b0\u1ee3c g\u1eafn v\u00e0o khung \u0111\u1ecbnh v\u1ecb ba chi\u1ec1u (Stereotaxy) \u0111\u1ecbnh h\u01b0\u1edbng d\u1eabn \u0111\u01b0a \u0111i\u1ec7n c\u1ef1c v\u00e0o n\u00e3o.<\/p>\n

–\u00a0B\u01b0\u1edbc 2:\u00a0<\/b>Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb v\u00e0 CT scan n\u00e3o<\/p>\n

–\u00a0B\u01b0\u1edbc 3:\u00a0<\/b>L\u1eadp tr\u00ecnh v\u1ecb tr\u00ed \u0111\u1eb7t \u0111i\u1ec7n c\u1ef1c, \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u00fang v\u1ecb tr\u00ed nh\u00e2n n\u00e3o n\u00e0o g\u00e2y ra tri\u1ec7u ch\u1ee9ng run, c\u1ee9ng \u0111\u1edd hay lo\u1ea1n \u0111\u1ed9ng. T\u00f9y thu\u1ed9c v\u00e0o m\u1ee5c ti\u00eau c\u1ee7a \u0111i\u1ec1u tr\u1ecb m\u00e0 \u0111\u1eb7t \u0111i\u1ec7n c\u1ef1c v\u00e0o:<\/p>\n

+ Nh\u00e2n d\u01b0\u1edbi \u0111\u1ed3i th\u1ecb: \u0111i\u1ec1u tr\u1ecb parkinson<\/p>\n

+ Nh\u00e2n c\u1ea7u nh\u1ea1t (ph\u1ea7n trong): lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 to\u00e0n th\u1ec3<\/p>\n

+ Nh\u00e2n b\u1ee5ng trung gian \u0111\u1ed3i th\u1ecb (Vim): ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb run v\u00f4 c\u0103n kh\u00e1ng tr\u1ecb.<\/p>\n

–\u00a0B\u01b0\u1edbc 4:\u00a0<\/b>\u0110\u1eb7t \u0111i\u1ec7n c\u1ef1c n\u00e3o s\u00e2u t\u1ea1i ph\u00f2ng m\u1ed5<\/p>\n

+ Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c g\u00e2y t\u00ea t\u1ea1i ch\u1ed7. L\u1eafp \u0111\u1eb7t h\u1ec7 th\u1ed1ng \u0111\u1ecbnh v\u1ecb<\/p>\n

+ V\u1ecb tr\u00ed khoan \u1edf ngay tr\u01b0\u1edbc kh\u1edbp tr\u00e1n – \u0111\u1ec9nh, c\u00e1ch \u0111\u01b0\u1eddng gi\u1eefa kho\u1ea3ng 2,5 cm, \u0111\u01b0\u1eddng k\u00ednh kho\u1ea3ng 1 cm. C\u00f3 th\u1ec3 1 b\u00ean ho\u1eb7c 2 b\u00ean.<\/p>\n

+ \u0110\u01b0a \u0111i\u1ec7n c\u1ef1c ghi v\u00e0o trong n\u00e3o \u0111\u1ed9 s\u00e2u v\u00e0 g\u00f3c ch\u1ebfch \u0111\u00e3 \u0111\u01b0\u1ee3c t\u00ednh to\u00e1n tr\u00ean m\u00e1y t\u00ednh v\u00e0 \u0111\u01b0\u1ee3c ki\u1ec3m tra b\u1eb1ng ch\u1ee5p C-arm trong m\u1ed5.<\/p>\n

+ L\u1ea7n th\u1eed s\u1ebd \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ea1i v\u1ecb tr\u00ed nh\u00e2n n\u00e3o b\u1ecb b\u1ec7nh v\u1edbi m\u1ed9t d\u00f2ng \u0111i\u1ec7n c\u00f3 c\u01b0\u1eddng \u0111\u1ed9 r\u1ea5t th\u1ea5p v\u00e0 theo d\u00f5i hi\u1ec7u qu\u1ea3 th\u1ef1c t\u1ebf c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh trong l\u00fac m\u1ed5. B\u00e1c s\u1ef9 n\u1ed9i th\u1ea7n kinh s\u1ebd x\u00e1c \u0111\u1ecbnh c\u01b0\u1eddng \u0111\u1ed9 d\u00f2ng \u0111i\u1ec7n k\u00edch th\u00edch d\u1ef1a tr\u00ean t\u00e1c \u0111\u1ed9ng ch\u1ed1ng run, \u1ea3nh h\u01b0\u1edfng kh\u1ea3 n\u0103ng \u0111\u1ecdc, nh\u00ecn.<\/p>\n

+ \u0110\u1eb7t \u0111i\u1ec7n c\u1ef1c k\u00edch th\u00edch: khi t\u1ea5t c\u00e1c th\u00f4ng s\u1ed1 \u0111\u00e3 x\u00e1c \u0111\u1ecbnh chu\u1ea9n, \u0111i\u1ec7n c\u1ef1c \u0111\u01b0\u1ee3c g\u1eafn c\u1ed1 \u0111\u1ecbnh v\u00e0o v\u1ecb tr\u00ed nh\u00e2n b\u1ecb b\u1ec7nh v\u00e0 \u0111i\u1ec1u ch\u1ec9nh th\u00f4ng s\u1ed1 c\u01b0\u1eddng \u0111\u1ed9 ph\u00f9 h\u1ee3p th\u00f4ng qua c\u00e1c k\u00eanh. \u0110i\u1ec7n c\u1ef1c \u0111\u01b0\u1ee3c \u0111\u1eb7t \u1edf d\u01b0\u1edbi da \u0111\u1ea7u v\u00f9ng \u0111\u1ec9nh ch\u1ea9m, v\u00e0 th\u00f2 \u0111\u1ea7u ngo\u00e0i ra ngo\u00e0i da.<\/p>\n

–\u00a0B\u01b0\u1edbc 5:\u00a0<\/b>B\u00e1c s\u1ef9 n\u1ed9i khoa s\u1ebd ki\u1ec3m tra \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 v\u1edbi thi\u1ebft b\u1ecb k\u00edch th\u00edch (IPG) v\u1edbi c\u00e1c c\u01b0\u1eddng \u0111\u1ed9 kh\u00e1c nhau v\u00e0 d\u1ef1a tr\u00ean hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng trong kho\u1ea3ng v\u00e0i ng\u00e0y \u0111\u1ebfn 1 tu\u1ea7n.<\/p>\n

L\u1ea7n m\u1ed5 th\u1ee9 2: <\/b>th\u01b0\u1eddng sau l\u1ea7n m\u1ed5 th\u1ee9 nh\u1ea5t 1 tu\u1ea7n<\/strong><\/p>\n

–\u00a0B\u01b0\u1edbc 6:\u00a0<\/b>C\u1ea5y thi\u1ebft b\u1ecb k\u00edch th\u00edch IPG \u1edf d\u01b0\u1edbi da v\u00f9ng ng\u1ef1c v\u00e0 d\u01b0\u1edbi \u0111\u00f2n.<\/p>\n

+ Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c g\u00e2y m\u00ea to\u00e0n th\u00e2n<\/p>\n

+ R\u1ea1ch da d\u01b0\u1edbi \u0111\u00f2n c\u00f9ng b\u00ean v\u1edbi \u0111i\u1ec7n c\u1ef1c n\u00e3o s\u00e2u<\/p>\n

+ T\u1ea1o \u0111\u01b0\u1eddng h\u1ea7m d\u01b0\u1edbi da t\u1eeb sau tai xu\u1ed1ng d\u01b0\u1edbi \u0111\u00f2n, v\u00e0 d\u00e2y d\u1eabn \u0111i\u1ec7n t\u1eeb d\u01b0\u1edbi da \u0111\u1ea7u xu\u1ed1ng d\u01b0\u1edbi \u0111\u00f2n, n\u1ed1i d\u00e2y d\u1eabn v\u1edbi \u0111i\u1ec7n c\u1ef1c \u0111\u00e3 c\u1ea5y v\u00e0o n\u00e3o.<\/p>\n

+ \u0110\u1eb7t thi\u1ebft b\u1ecb k\u00edch th\u00edch IPG d\u01b0\u1edbi \u0111\u00f2n, n\u1ed1i v\u1edbi d\u00e2y d\u1eabn \u0111i\u1ec7n.<\/p>\n

+ Thi\u1ebft l\u1eadp ch\u01b0\u01a1ng tr\u00ecnh ho\u1ea1t \u0111\u1ed9ng c\u1ee7a IPG. To\u00e0n b\u1ed9 thi\u1ebft b\u1ecb n\u00e0y ho\u1ea1t \u0111\u1ed9ng nh\u1edd v\u00e0o m\u1ed9t vi\u00ean pin \u0111\u01b0\u1ee3c \u0111\u1eb7t \u1edf d\u01b0\u1edbi da v\u00f9ng ng\u1ef1c. Tu\u1ed5i th\u1ecd pin trung b\u00ecnh l\u00e0 5 n\u0103m t\u00f9y thu\u1ed9c v\u00e0o c\u01b0\u1eddng \u0111\u1ed9 \u0111i\u1ec7n s\u1eed d\u1ee5ng cao hay th\u1ea5p.<\/p>\n

4. Theo d\u00f5i v\u00e0 x\u1eed l\u00ed tai bi\u1ebfn<\/b><\/h2>\n

4.1. Theo d\u00f5i:<\/b><\/h3>\n

– Sau m\u1ed5 ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u00e0 theo d\u00f5i t\u1ea1i ph\u00f2ng h\u1ed3i t\u1ec9nh sau m\u1ed5 \u0111\u1ec3 cai m\u00e1y, r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n.<\/p>\n

– Theo d\u00f5i ch\u1ea3y m\u00e1u v\u1ebft m\u1ed5, t\u00ecnh tr\u1ea1ng tri gi\u00e1c, c\u01a1n co gi\u1eadt<\/p>\n

– Sau l\u1ea7n m\u1ed5 th\u1ee9 nh\u1ea5t: b\u00e1c s\u1ef9 n\u1ed9i th\u1ea7n kinh s\u1ebd d\u00f2 c\u01b0\u1eddng \u0111\u1ed9 d\u00f2ng \u0111i\u1ec7n th\u00edch h\u1ee3p nh\u1ea5t v\u1edbi ng\u01b0\u1eddi b\u1ec7nh tr\u01b0\u1edbc khi m\u1ed5 l\u1ea7n th\u1ee9 2 \u0111\u1eb7t d\u1ee5ng c\u1ee5 k\u00edch th\u00edch \u0111i\u1ec7n IPG v\u0129nh vi\u1ec5n.<\/p>\n

– Hi\u1ec7u qu\u1ea3: run s\u1ebd gi\u1ea3m 80-90%, c\u1ee9ng \u0111\u1edd gi\u1ea3m t\u1eeb 70-80%, \u0111\u1eb7c bi\u1ec7t bi\u1ebfn ch\u1ee9ng r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng g\u1ea7n nh\u01b0 kh\u00f4ng c\u00f2n. Sau ph\u1eabu thu\u1eadt, ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u n\u1eb1m vi\u1ec7n th\u00eam m\u1ed9t th\u1eddi gian n\u1eefa \u0111\u1ec3 theo d\u00f5i, \u0111i\u1ec1u ch\u1ec9nh c\u01b0\u1eddng \u0111\u1ed9 d\u00f2ng \u0111i\u1ec7n cho ph\u00f9 h\u1ee3p, t\u1eadp v\u1eadt l\u00fd tr\u1ecb li\u1ec7u v\u1eadn \u0111\u1ed9ng t\u1ea1i ch\u1ed7 v\u00e0 \u0111i l\u1ea1i.<\/p>\n

4.2. X\u1eed l\u00fd tai bi\u1ebfn:<\/b><\/p>\n

– Ch\u1ea3y m\u00e1u: m\u00e1u t\u1ee5 trong n\u00e3o (0,6%), ch\u1ea3y m\u00e1u n\u00e3o th\u1ea5t (0,6%), m\u00e1u t\u1ee5 d\u01b0\u1edbi m\u00e0ng c\u1ee9ng (0,6%). Ch\u1ee5p c\u1eaft l\u1edbp ki\u1ec3m tra \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 v\u00e0 \u0111i\u1ec1u tr\u1ecb.<\/p>\n

– Nhi\u1ec5m tr\u00f9ng: Th\u01b0\u1eddng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c s\u1ebd kh\u1ecfi. Tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m tr\u00f9ng n\u1eb7ng ph\u1ea3i th\u00e1o b\u1ecf \u0111i\u1ec7n c\u1ef1c.<\/p>\n

– R\u1ed1i lo\u1ea1n ng\u00f4n ng\u1eef: \u0110i\u1ec1u ch\u1ec9nh l\u1ea1i c\u01b0\u1eddng \u0111\u1ed9 d\u00f2ng \u0111i\u1ec7n \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee9c \u0111\u1ed9 th\u00edch h\u1ee3p gi\u1eefa hi\u1ec7u qu\u1ea3 ki\u1ec3m so\u00e1t run – r\u1ed1i lo\u1ea1n ng\u00f4n ng\u1eef.<\/p>\n

– \u0110\u1ed9ng kinh (1,2%): c\u1ea7n ch\u1ee5p c\u1eaft l\u1edbp \u0111\u1ec3 ki\u1ec3m tra xem c\u00f3 nguy\u00ean nh\u00e2n do m\u00e1u t\u1ee5 g\u00e2y ra hay kh\u00f4ng<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"

B\u1ec7nh Parkinson l\u00e0 b\u1ec7nh tho\u00e1i ho\u00e1 c\u00e1c t\u1ebf b\u00e0o th\u1ea7n kinh h\u1ec7 dopaminergic. Nguy\u00ean nh\u00e2n c\u1ee7a b\u1ec7nh do tho\u00e1i ho\u00e1 c\u1ee7a c\u00e1c t\u1ebf b\u00e0o trong v\u00f9ng \u0111\u1eb7c c\u1ee7a li\u1ec1m \u0111en v\u00e0 li\u1ec1m xanh. K\u00edch th\u00edch n\u00e3o s\u00e2u (deep brain stimulation- DBS) v\u00e0o nh\u00e2n d\u01b0\u1edbi \u0111\u1ed3i th\u1ecb \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho ng\u01b0\u1eddi b\u1ec7nh Parkinson th\u1ea5t b\u1ea1i […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nPh\u01b0\u01a1ng ph\u00e1p \u0111\u1eb7t \u0111i\u1ec7n c\u1ef1c s\u00e2u \u0111i\u1ec1u tr\u1ecb b\u1ec7nh Parkinson - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh Parkinson l\u00e0 b\u1ec7nh tho\u00e1i ho\u00e1 c\u00e1c t\u1ebf b\u00e0o th\u1ea7n kinh h\u1ec7 dopaminergic. Nguy\u00ean nh\u00e2n c\u1ee7a b\u1ec7nh do tho\u00e1i ho\u00e1 c\u1ee7a c\u00e1c t\u1ebf b\u00e0o trong ...\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ph\u01b0\u01a1ng ph\u00e1p \u0111\u1eb7t \u0111i\u1ec7n c\u1ef1c s\u00e2u \u0111i\u1ec1u tr\u1ecb b\u1ec7nh Parkinson - Vinmec\" \/>\n<meta property=\"og:description\" content=\"B\u1ec7nh Parkinson l\u00e0 b\u1ec7nh tho\u00e1i ho\u00e1 c\u00e1c t\u1ebf b\u00e0o th\u1ea7n kinh h\u1ec7 dopaminergic. 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